Gutenberg Open Science: The bigger the better? : Center volume dependent effects on procedural and functional outcome in established endovascular stroke centers

Please use this identifier to cite or link to this item: http://doi.org/10.25358/openscience-8650

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DC Field	Value	Language
dc.contributor.author	Hahn, Marianne	-
dc.contributor.author	Gröschel, Sonja	-
dc.contributor.author	Tanyildizi, Yasemin	-
dc.contributor.author	Brockmann, Marc A.	-
dc.contributor.author	Gröschel, Klaus	-
dc.contributor.author	Uphaus, Timo	-
dc.contributor.other	German Stroke Registry-Endovascular Treatment (GSR-ET) Investigators	-
dc.date.accessioned	2023-02-17T08:10:03Z	-
dc.date.available	2023-02-17T08:10:03Z	-
dc.date.issued	2022	-
dc.identifier.uri	https://openscience.ub.uni-mainz.de/handle/20.500.12030/8666	-
dc.description.abstract	Background: Mechanical thrombectomy (MT) rates for the treatment of acute ischaemic stroke due to large vessel occlusion are steadily increasing, but are delivered in heterogenic settings. We aim to investigate effects of procedural load in centers with established MT-structures by comparing high- vs. low-volume centers with regard to procedural characteristics and functional outcomes. Methods: Data from 5,379 patients enrolled in the German Stroke Registry Endovascular Treatment (GSR-ET) between June 2015 and December 2019 were compared between three groups: high volume: ≥180 MTs/year, 2,342 patients; medium volume: 135–179 MTs/year, 2,202 patients; low volume: <135 MTs/year, 835 patients. Univariate analysis and multiple linear and logistic regression analyses were performed to identify differences between high- and low-volume centers. Results: We identified high- vs. low-volume centers to be an independent predictor of shorter intra-hospital (admission to groin puncture: 60 vs. 82 min, β = −26.458; p < 0.001) and procedural times (groin puncture to flow restoration: 36 vs. 46.5 min; β = −12.452; p < 0.001) after adjusting for clinically relevant factors. Moreover, high-volume centers predicted a shorter duration of hospital stay (8 vs. 9 days; β = −2.901; p < 0.001) and favorable medical facility at discharge [transfer to neurorehabilitation facility/home vs. hospital/nursing home/in-house fatality, odds ratio (OR) 1.340, p = 0.002]. Differences for functional outcome at 90-day follow-up were observed only on univariate level in the subgroup of primarily to MT center admitted patients (mRS 0–2 38.5 vs. 32.8%, p = 0.028), but did not persist in multivariate analyses. Conclusion: Differences in efficiency measured by procedural times call for analysis and optimization of in-house procedural workflows at regularly used but comparatively low procedural volume MT centers.	en_GB
dc.description.sponsorship	Gefördert durch die Deutsche Forschungsgemeinschaft (DFG) - Projektnummer 491381577	de
dc.language.iso	eng	de
dc.rights	CC BY	*
dc.rights.uri	https://creativecommons.org/licenses/by/4.0/	*
dc.subject.ddc	610 Medizin	de_DE
dc.subject.ddc	610 Medical sciences	en_GB
dc.title	The bigger the better? : Center volume dependent effects on procedural and functional outcome in established endovascular stroke centers	en_GB
dc.type	Zeitschriftenaufsatz	de
dc.identifier.doi	http://doi.org/10.25358/openscience-8650	-
jgu.type.contenttype	Scientific article	de
jgu.type.dinitype	article	en_GB
jgu.type.version	Published version	de
jgu.type.resource	Text	de
jgu.organisation.department	FB 04 Medizin	de
jgu.organisation.number	2700	-
jgu.organisation.name	Johannes Gutenberg-Universität Mainz	-
jgu.rights.accessrights	openAccess	-
jgu.journal.title	Frontiers in Neurology	de
jgu.journal.volume	13	de
jgu.pages.alternative	828528	de
jgu.publisher.year	2022	-
jgu.publisher.name	Frontiers Research Foundation	de
jgu.publisher.place	Lausanne	de
jgu.publisher.issn	1664-2295	de
jgu.organisation.place	Mainz	-
jgu.subject.ddccode	610	de
jgu.publisher.doi	10.3389/fneur.2022.828528	de
jgu.organisation.ror	https://ror.org/023b0x485	-
jgu.subject.dfg	Lebenswissenschaften	de
Appears in collections:	DFG-491381577-G

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